Strategic Framework for Imaging Services in Health and Social Care

The Southern Trust needs to act at once to provide 2 CT Scanners as part of the VITAL diagnostic imaging services in Daisy Hill Acute Hospital, Newry city to meet their statutory duty of care and honour the promises they made in official statements (during the 2014 Stroke Consultation).

It is imperative that a NEW permanent replacement CT scanner and a second NEW CT scanner get Commissioner Approval and are installed AT ONCE in Daisy Hill Acute Hospital to give access to life saving DIAGNOSTIC treatment to save the lives of stroke and heart patients and for other medical emergencies.

IMAGING REVIEW

The Imaging Review Consultation stated the need FOR TWO CT scanners in 24/7 Emergency Departments to ensure resilience when one scanner breaks down so that another one is readily available – when patients URGENTLY need a CT scan.

Every second counts in getting a CT scan to save patients lives and give better outcomes for stroke and heart and other critical medical conditions.

CT SCANNING NEEDED TO CONFIRM TYPE OF STROKE – whether bleed or clot.

Major research into the Stroke pathway confirms the importance of diagnostic CT scanning to eliminate brain bleed for suitability for thrombolysis.

The Southern Trust needs to use the same urgent priority planning to address the needs for provision of imaging services for the Newry & Mourne population (the largest locality population in the Southern Trust), as well as addressing the needs of the Craigavon population, which has only the second largest Locality population in the Southern Trust.

In Craigavon, as the Trust Delivery Plan shows, advanced plans are already in place, with Commissioner Approval, for 2 NEW CT scanners, a new twin CT screening room and 1 more NEW MRI scanner. (Two NEW MRI scanners were already installed in Craigavon Hospital in 2014 and 2015).

REFRESH SOUTHERN TRUST IMAGING PLANS

The promises made in a series of official statements, three of which are detailed below, cannot be honoured by the Southern Trust without the provision of continuous CT scanning facilities in Daisy Hill ED, Newry City.

These promises can only be kept if the Southern Trust plan well in advance for replacement CT scanners so that the 7 year Royal College of Radiologists (RCR) recommended replacement timescale for functional life of a CT scanner is adhered to in Daisy Hill, in the same urgent manner as imaging services are planned for in Craigavon Hospital.

The Southern Trust’s IMAGING Plans must be refreshed to change the designated “non priority” for replacement of Daisy Hill’s existing CT scanner to “CAPITAL PRIORITY” and for a second new CT Scanner also as a “Capital Priority.”

The following promises were made by Southern Trust Personnel in Documents as listed below:

>STATEMENT 1:

‘STROKE CARE PROMISE’ (Newry Reporter: 27/08/2014)

“Emergency Treatment (for Stroke) will always be around the clock. If a clot busting drug is required, ….we aim to deliver a door to needle time of 60 minutes INCLUDING A CT SCAN PROVIDED AT BOTH HOSPITALS.”

(Southern Trust Director of Acute Services, Newry Reporter: 27 Aug 2014, Front page p 1, p 4)

>STATEMENT 2:

“Patients who have suffered a stroke will always get IMMEDIATE DIAGNOSIS and emergency treatment, including thrombolysis AT BOTH of our Emergency Departments in Daisy Hill Hospital and Craigavon Area Hospital. This will ensure we can continue to achieve a ‘door to needle’ time of 60 minutes for thrombolysis.”

(Southern Trust Stroke Consultation Document, p.14, June 2014)

>STATEMENT 3:

“People with symptoms of stroke are always taken first to the Emergency Department in either Daisy Hill Hospital or Craigavon Area Hospital for ASSESSMENT and treatment and our proposals would NOT change this”.

(Chief Executive of the Southern Health Trust, Launch of the Stroke Consultation, Southern Trust Press release 19/06/2014.)

CALL FOR ACTION FROM SOUTHERN TRUST NOW

A NEW permanent replacement CT scanner and a second NEW CT scanner must now be a CAPITAL PRIORITY, get Commissioner Approval, and be installed immediately in Daisy Hill Acute Hospital to give access to life saving DIAGNOSTIC treatment to save the lives of stroke and heart patients and for other medical emergencies.

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The urgent need for MRI and CT scanning equipment in Daisy Hill Acute Hospital, Newry for now and the future, was pointed out by many people in responses to the Draft Consultation called ‘Strategic Framework for Imaging Services in Health and Social Care’, (which closed in January 2018.)

The Department of Health NI has published the Final Framework and Summary of Responses documents on their website. (Links are available below)

WAITING LISTS GROW IN THE SOUTHERN TRUST

As demand for diagnostic MRI and CT scans in the Southern Trust area increases, this need for more imaging equipment becomes more urgent.

Of the 5 Health Trusts in Northern Ireland – the Southern Trust had the HIGHEST number of people (26,383) on the URGENT Waiting list in need of CT diagnostic scanning, out of 34,137 people waiting for CT scans in the Southern Trust. (for the period 31st July 2017 – 30th June 2018).

The Southern Trust also had the 2nd highest number of people in NI on the URGENT waiting list for diagnostic MRI scans during the same period (9,419 people).

Providing extra CT and MRI scanners in Daisy Hill Acute Hospital, Newry – in the largest locality in the Southern Trust would improve these waiting lists.

However there is NO CAPITAL INVESTMENT PROPOSED as a PRIORITY for the replacement of the eight year old CT Scanner, or new MRI and CT scanners in DAISY HILL ACUTE HOSPITAL (for 2014 to 2022).

Source: Imaging Review Equipment Management Document, see pg 31/32 table extract shown below *

Extracts from this document show plans for proposed CT/MRI Scanning Equipment Investment (2014 – 2022) and the level of priority the Trust assigns it.

New/Replacement equipment is NOT a TRUST PRIORITY for DAISY HILL Acute Hospital, Newry City.

Trust Priority EQUIPMENT £ Est. Cost

NOT A PRIORITY; MRI SCANNER Daisy Hill £500k for 2016/17

NOT A PRIORITY; CT SCANNER Daisy Hill £500k for 2016/17

In the same period, the Trust assigns Priority 1, 2, 3 (2014 – 2022) for CT/MRI equipment for CRAIGAVON Hospital at a TOTAL COST of nearly £4.5 MILLION

Trust Priority EQUIPMENT £ Est. Cost

PRIORITY 1;          2ND NEW CT Scanner    £2 million       for 2015 /16
PRIORITY 2;          2ND MRI Scanner          £1.5 million    for 2014/15
PRIORITY 3;          UPGRADE CT Scanner    £495K            for 2015/16
PRIORITY 3;          UPGRADE CT Scanner    £500K            for 2021/22

Trust priority 1, 2, 3 (2014 – 2022) for CRAIGAVON > TOTAL COST nearly £4.5 MILLION

(Source: Imaging Review Equipment Management Document, see pg 31/32 table)

£62.8 MILLION PROPOSED INVESTMENT FUNDING 2014/15 – 2022 FOR IMAGING EQUIPMENT IN NI

Under the ‘Proposed Major Equipment Investment Programme’ (see Annex D Equipment Management Document) – all five Health Trusts in NI have asked for a total of £62.8 million from the Department of Health for New and Replacement of major imaging equipment (from 2014/15 to 2022) under Royal College of Radiologists guidelines.

The Trust have asked for nearly £4.5 million of this proposed Investment as a Trust Priority for CT and MRI scanning equipment for Craigavon only between 2014 to 2022.

One proposed new CT scanner in Craigavon Hospital for 2015/16 (Trust Priority 1) was itemised to cost £2million, this is enough money to pay for one Necessary MRI scanner as well as 1 Vital CT scanner in Daisy Hill Acute Hospital, Newry City.

Daisy Hill Hospital is not even down as a Trust Priority to get a REPLACEMENT CT scanner (to replace the CT scanner which was installed in 2010) even though the Royal College of Radiologist guidelines should be adhered to.

DEMOGRAPHICS (population)

Using the latest population estimates (June 2017), Newry & Mourne Locality has the largest Local population (105,161) of the five former Local Government Districts of Newry & Mourne, Banbridge, Dungannon, Armagh and Craigavon in the operational area of the Southern Trust.

Daisy Hill Acute Hospital, Newry city should currently have at least TWO NEW diagnostic MRI and 2 NEW CT scanners, plus a NEW MOBILE SCANNER and NEW SCREENING ROOMS, as in Craigavon Local Government District (which always had a smaller Local Government District or Locality population.)

Do you agree? If so, please continue to speak up for Daisy Hill. Continued support from the Community, Politicians, Individuals, Trade Unions and businesses on this issue is URGENTLY NEEDED NOW.

BACKGROUND INFO & LINKS

Links to the Strategic Framework for Imaging Services in Health and Social Care Consultation documents referred to in this article are below:

*Link to Imaging Review Equipment Management doc – https://www.health-ni.gov.uk/sites/default/files/consultations/health/Imaging%20Review%20%20Equipment%20Management%20pdf.pdf (See pages 31 -32 for Southern Trust planned Investment including Daisy Hill Hospital)

https://www.health-ni.gov.uk/sites/default/files/publications/health/IR-responses.pdf

https://www.health-ni.gov.uk/publications/strategic-framework-imaging-services-health-and-social-care